Abstract
Objective. This study presents a clinical and histological evaluation of human pulp tissue responses after direct capping using a new dentin adhesive system. Methods. Twenty-eight caries-free third molar teeth scheduled for extraction were evaluated. The pulps of 22 teeth were mechanically exposed and randomly assigned to 1 of 2 groups: Single Bond Universal or calcium hydroxide. Another group of 6 teeth acted as the intact control group. The periapical response was assayed, and a clinical examination was performed. The teeth were extracted after 6 weeks, and a histological analysis was performed. The pulp status was assessed, and the thickness of the dentin bridge was measured and categorized using a histological scoring system. Results. The clinical phase was asymptomatic for Single Bond Universal patients. Patients in the calcium hydroxide group reported mild symptoms of pain, although the histological examination revealed that dentin bridges with or without limited pulpitis had begun forming in each tooth. The universal adhesive system exhibited nonsignificantly increased histological signs of pulpitis (P > 0.05) and a significantly weaker thin mineralized tissue layer (P < 0.001) compared with the calcium hydroxide group. Conclusion. The results suggest that Single Bond Universal is inappropriate for human pulp capping; however, further long-term studies are needed to determine the biocompatibility of this agent.
Highlights
Direct pulp capping is one of the oldest known treatments for exposed pulp, and more efficient materials and approaches are continuously sought [1,2,3,4]
The introduction of calcium hydroxide (Ca[OH]2) in dentistry has played an important role in the development of a biological treatment for exposed pulp, because of its potent antibacterial properties and its ability to stimulate reparative dentin formation, markedly increasing the success rates of clinical procedures [1, 6,7,8,9]
Dentin adhesive systems have been investigated in humans [1, 2, 6, 9, 12, 13] and animals [7, 8, 14,15,16] as potential direct pulp capping materials because of their superior ability to adhere to demineralized dentin tissues
Summary
Direct pulp capping is one of the oldest known treatments for exposed pulp, and more efficient materials and approaches are continuously sought [1,2,3,4]. New pulp capping techniques may stimulate pulp healing without toxic chemical effects, providing better results than Ca(OH)2 [2,3,4, 11]. Dentin adhesive systems have been investigated in humans [1, 2, 6, 9, 12, 13] and animals [7, 8, 14,15,16] as potential direct pulp capping materials because of their superior ability to adhere to demineralized dentin tissues. Hybridization of dentin bonding and diffusion of adhesives into the dentin tubules may protect the dentin against bacterial leakage and thereby reduce secondary pulpal
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